| Source HCPCS Code |
|
Target NDC Code |
J2781
INJECTION, PEGCETACOPLAN, INTRAVITREAL, 1 MG
|
⇄
|
73606-0020-01
SYFOVRE (PF) 15 MG/0.1 ML
|
| Detail Information |
| Relationship Start Date |
10/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IO |
| Billing Units |
ML |
|
|
|
J2781
INJECTION, PEGCETACOPLAN, INTRAVITREAL, 1 MG
|
⇄
|
73606-0020-02
SYFOVRE CO-PACK KIT 15 MG/0.1 ML
|
| Detail Information |
| Relationship Start Date |
10/10/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IO |
| Billing Units |
ML |
|
|
|
J2781
Inj, pegcetacoplan, 1mg
|
⇄
|
73606-0020-01
Syfovre
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|
J2781
Inj, pegcetacoplan, 1mg
|
⇄
|
73606-0020-02
Syfovre
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|